Objective 3: Foster Research on Health Promotion and Restoration, Resilience, Disease Prevention, and Symptom Management
NCCIH’s research investments in understanding the role of complementary and integrative health approaches in health promotion and restoration, resilience, disease prevention, and symptom management are in part informed by data on the complementary products and practices that people use. These data include what groups of people use them, why they use them, how their use has changed over time, and how their use relates to health outcomes.
Complementary and integrative health care includes the patient–provider alliance, provider-delivered interventions, and the patient taking ownership of the care. Survey data have revealed that people who use complementary and integrative approaches for wellness differ in significant ways from those who use them to treat an illness. For example, an analysis of National Health Interview Survey data showed that wellness-oriented users of complementary approaches were generally healthier, had a lower rate of conventional health services use, and had healthier behaviors overall, including greater physical activity and a lower likelihood of obesity, than those who used complementary approaches to treat illness. This suggests that access to and utilization of complementary and integrative approaches may empower patients to take charge of their health.
Surveys are only a first step in gaining knowledge about health-related behavior. More focused research is needed to understand why people make healthy, unhealthy, or risky choices; find out what choices people are making on a day-to-day basis, including self-care; and elucidate the impact these choices may have on short- and long-term health. New technologies, such as wearables, have improved the ways in which data can be obtained to measure a variety of behaviors. Current studies can also harness state-of-the-art technologies and approaches from the neurobiological, biomechanical, and biological sciences to elucidate biological effects and identify mechanisms of action of behaviors and interventions of interest. Researchers may also leverage existing databases to provide real-world insights into health and health care.
Managing symptoms–particularly recurring or chronic symptoms such as anxiety, headache, insomnia, and back, neck, or joint pain–is challenging. Symptoms may change over time, and patients may experience multiple symptoms in clusters (e.g., pain, sleep difficulties, and mood changes) rather than a single symptom in isolation. Current approaches to symptom management often have limitations and often do not optimally engage patients in self-management. Despite medical treatment, some patients continue to experience troublesome levels of symptoms and a diminished quality of life. Moreover, medications used to treat symptoms may have significant risks and side effects.
Expanding the knowledge base about how complementary health approaches may improve symptom management in both the short and long term is a priority for NCCIH. There is a growing body of basic and clinical research on complementary health approaches for symptom management that employs the methods, tools, and technologies of neuroscience, psychoneuroimmunology, psychology, behavioral medicine, physical medicine, and biomechanics. For example, research studies have revealed that interventions such as meditation and acupuncture affect central mechanisms of pain perception and processing, regulation of emotion and attention, and placebo responses. Although not yet fully understood, these effects point toward scientifically plausible mechanisms–often unrelated to traditional explanations or hypotheses concerning their mechanisms of action–by which these interventions might be effective.